-t

3/24/2014
f
t

The "Window of Opportunity/ for lmproving

Nutrition is very small...pregnancy until 1g-24
months of age
0.50
o.25

o o.m
! -o.zs

! -oso
| -o.zs
3 -1.0o
j.25
!
s -t.5o
lt''
-2m
0 3 6 9 12151A212427303336394245€s154s780
Agc (modh3l
 3/24/2AL4

Foktor liqgkurEan yaqg mempengoruhi

proktek pemberion mokon poda bcyi :
1. Tit€il(of nokro : - ekommi nrekno
- UU perburuhoa
- prokf"k dogaq perusohaon
- bqrcm olon. dll.
2. Tingkaf nosyorokof : - budoyo don agorm
- urban vs rurol
- peloyomn kesehctcn onal
- p.Fahron di tcnpoi kcrjo,on
3. Tingkot nrmohto4ggu : - peirdcpoton, lcsejahter"oon,
sw$er perghosilon
-
otgrg.lcluorya, petg[suh. dll
4. Tiryltat pengcsuh : - pendidikan, lcsahcton & sf gizi
- faktor psilososial, dll

IHFANT FEEDING PERIODs

lp-aoro"*auoi ffiPlwelay leedrg

t
Ur" Uolry ts6od ol

Ohild&e
 3/24/2014

Bayi dengan A$l

eksklusif :
Inisiasi Menyusu Dini (IMD)

Tidak boleh diberi MP-ASI

sebelum usia 6 bulan !!

Tetapi juga tidak boleh ditunda

sampai melewati usia 6 bulan l!
 -

3/24/20L4

PROFII.€ OS EXCLUSIF EREA$T FEEDING

Benefits of Bneostfaeding

. contoins tlp beSt ngtrient5 fi

^nDtr^soc.1ee7:e7:6622,1,)
. fhe imltdlne subsfonces and enaymas conlainingtutudhn
AiH tul#.t997 133 281-2e (3): FolM sI Mb
h,fd,E Sr of ffil
buB,AAlbSy:!993 (a)
. impr"ove moternol llealth v.u*ta p.*l'dtutuwchineb,oc:wl
Aadery of S.be:1991(5)
. Econonicol rzl
. It sfr^engrthens lhe relationship between nother ond
child pq;chology te,r,rl
. Loqrer Respirotor"y qnd 6I Trocf inf(*aari*.rsez:gg(6),ase(e)
' the boby looked thinner ot 09€ I yaorrchur'ree35,:14o
r45.C4
. Better cognitive develoPmentol

Composition Of Brcost liilk

Mengapa ASI? composition of Breast lltilk lories: between mother, during ldcfotion,
brectfe€dihg time per day, during breostfeeding ond moternol diel

60lostrutn
days of Breosi liilk cfier childbirth
in fof and enargy,
in protein, fct-soluble vit. mirerols, elearolytes and antibodies (4,1)

tlilk
i The 7th doy of the nother's Breast Ittilk uP to the 141h doy after
!'-_____ childbirth
if
! i Limfosit Raduced protein and total lrnunoglobulin
Lcctose, fot ond totol calories is incrosing (1,5).

Susu formula tidak mungkin rftilk

menyamaiASl The Zed week of Breost Milk up to the 7th month

4
 3/24/20L4

Bncsf rnilk ofter 7 months up to iwo yeans ,Asrerml Dlet drning Bnecstfeedlng
During pregnoncy'the mother prepored for breostfeeding :

increose in breost tissue

The content of fot, CH and protain relatively more stoble
storoge for enerEy and nutrienis,
*rsrls ond vitomins are reduced
4 L7 F, d€|. &eddllslumod corFo3itud$itg lds h.dhcr-2o dttu) f
b kah$l M.r984:3:713-7?OC4 kon ffv.dtstgE h +..itic nuftd h bld Dlet rccomrnsrdatlons for br"ccsffeediqg mothrr:
* tq dbd.d laeiqrh. ln J dh e.D85l€:49$5o3(6)
o balonced diet, odding 500 Kcol, supplementotion Vit. minerols.
- ihe ossumption for the production of 750-800 ml Breast tllilk
Ilu:asing Breost itilk production throughout the doy - et\e(Ey reserves as of 2-3 kg of body fot (addition of BB while
dring hctotion pregnont)
l- !H dol- Cltuldd fbld ttudk huM
During breastfeeding mothers feel thirsty ond drinking lots of.
Gt
6 : Ethodohgidl sidrdidt.Ah J Clin
utt=35:745 (9) No dola befween o lot of drinking and the production of BIII
The fd content increoses each towords the end of Regular exercise ond losing weight to ? kglmonth does not
l-aiction offect the production of BrtA

F aafEBilg 6i?o.ituof h!@ nillkdd dly dcEloPdotq.nt ffi|.

dfEj:z9 (1o)
77

It should bc not d Foctors fhof can offcct fhe durotion of breostfeeding :

1. The quolity of Bjtrl ore reiained, olthough moternol nutrition . IMD (Shortly nursing)
sfofus less thcn normal . Breostfeeding Positions should be comfortobleond not
2. The influence of diet on the rnother's Btlt\ complicote the mother
- The Volume of Bl|l declined when mothers who . Lotching on.
ore having less eneegy, CH ond or protein lruau"i*.trat,e*o* . Time.: the first weak of brecstfeeding, freguency 8-
- chonges in fotty ocid cornposition because of the mother's lZ/day or 2-3 tirnes/hour ond 1O - 15 nrinuie
intake intervol/interrritfent eoch breost
- the content of vitomin ond ninerols . Assess the adequocy of BAA/colories:
- symptoms of colic in infants of mothers who dronk cow's
6 - 8 times o doy changing diaPers
milk
Regulor bowel movenant
- of coffeirre, nicotine ond alcohol
o high consumption
- drugs and environmentol contominotion Suckle 8-12 tirres o dcy
colm down ond foll osleep ofter sucking
Weight goin a
 3/24/20L4

tagaimana Garanya?
a
@G
qI +W
,(t(i\

&_{zeft}
Y^,i,)\'r,!t$

The Workirq lAother

Lffl- of nnsirrg:
1. Ruong penitipon bcyi don menyusui di tempot kerja
t-fu$ rippbs sore becouse the lyrong position (lotching
.{ 2. melolui susu ibu peroh
3. stop semehtoro sementora bekerjo don dilonjutkon
Lluerfzels helvy ond poinful.
LI*ic nehyusui setelah pulong.
Sng bss dekuot. (l.kmrh il.SEdfadirB ad r|'. elking mthcrt Abfrq.l9g697t1fl?4A 02\

k fcedirg nora often. the supply of brecst rnilk ond

LrlosEd p€ris?olsis, reduce theibiorption of
Edtin
tQdrologicdty feel less BAr1 producfion.
t-Urltigrmther
 3/24/2014

IF
Bagaimana Menyimpan ASI?

3:
r lr'r I

ttu_l

KTU PENYIMPANAN ASI Formulo sfondard:

- dr miryok nobsti, KH dan mengrurongi prot.
sr.rsu sopi :lemok
d* <an k sld.d in t* tdrlowiq FsP:
- mengcndung whey yong sudoh di-deminerolisosi.
' ---:-\
.
,,r.-j,., ui r
,ir._. F i(.: l
I
j
Whey: cosein :60:4O.
I -..,rr Colustrum 80:20 tua.a.gsaTo:2zt {r3)& F&Asr nwr 55:€. J
,t"'-l tudil98je:27-(14)
lr
rl - Stondar formulo yang tidok whey demi*arolised rotio 20:8O
,r.i,,r - Belum odo doto ilmioh yong mendukung kelebihon formulo
stondor dengon penombohon whey yong sudoh
dideminerolized.(13)
- Kebutuhon prof. dolom fornulo boyi 1,8 - 4,5 grl 1@ Kccl.
€*) @b

Diperkoyo Tourin, besi (12 mglquorf (1,136 L) don yang

{, rendoh besi rnengondung 1 rnglquori). Besi diobsorbsi sekitor
i 4% .re' la*u'.rgm,r:'go (rt)
hr{d&..dM* r 24 Fou,s I r *-
 3/24/2014

onnulo Kocong Kedelci

Protein hidrolisat
1. Indikosi: intolercn loktoso. goloktosemio.don olergi susu sopi.
5O-60% boyi olergi pror suju scpi jugo otergi
- mengondung metionin, kornitin., froi kllehi. 1. kasein hidrolisat, olergi prot susu sopi atdu
2. difortifikasi icurin, rninyak
ncboti , KH loin seloin laktoso don besi. Kondunqdn p.ot"in f1gg9 kedelai. peprido ridok ontigenik, BM <
t20o.
lebih tinggi dari formula susu sopi, nitoi Uiotogif<nylieUitr
?.Whey Hidrolisot. peptido BM > Z0OO. ufk va
rendah.
sensitif prot susu sopi/ kedelai
3. beAeropo formulo tidok mengcndung sukroso don
tepung 3. Sumber KH don lernok bervariosi
Jagung.
d:^ fiber oligisokorida
dpr rnenggonggu absorbsi ca,
----t Pertimbongon
l!4:1
posfor, seng don b€si. Kodcr AAP: belum cukup bukti untuk bcyi dengon kolik,
co don posfor 2b% lbh'_j""'
tinggi dr
formula susu sopi. Tidak dianjurkan'boyi pr"t".^ gdngguon tidur otau iritobel
osfeopenio don mengondung qlumunium ___'+gg pertumbuhan

Formulc loqiutan Suplenentosi vitcmin don miiEEi-

Asr s.gr
iAemenuhi kebutuhon boyi >6 bulon
Vif K soot lohir 0,5 - 1 mg im sono
ieloh mendcpot MP ASI, tidok cukup nendopat nutrien l,O - 2,0 m9 po
Vit D 4OO ID khusus boyi resiko finggi-
protein lebih tinggi (3
9rl100 Kcol). Besi tng/kgbb rnox 15 mglhr somo, usio 4 bl
Mp ASI tinggi KH , rendoh lernok
usio 4_6 bl fonnulq forfifikosi
n

Formulo lcnjufor+
U
boik sebcgoi sunber Viiomin don
Fluorida o,Z5 ng/hrsesudah usio 6 bl ?h:::ff.
besi-
sumber oir <0,3 ppm Fl formula sicp
- dininum
Lihot bayi yang ot risk
s Formulq koyo besi (ZO
Kcol/oz dan lZ mg besi/quart)
Resiko kekurongon vir D podc boyi di ASr
urbcn bcgicn uiaro/ Timur Lout , rnusim dingin.
rliakanon Sopihcn

keseirnbcngon nuirien, voriasi makonon, don fekstur

rnoksnon
fose tronsisi/ perolihon
mokonon cair ---) sefengoh podot
--) podof
usio 4-6 bulon --) fisik don psikologik sudah sicp.

A$l + nilP-A$l Mengapa harus diberikan Mp.ASl

pada usia 6 bulan?
Proses penyapihan fweaningJ :
. prosec dimulainya pQlhHan makama ldtusts
. s.{ain ASI secara b€rtahap igtis, lGtsistensi, 3EFryytftryb.*ilmth Ef,Etry@o
tel(stJr, sampai scluruh kebutrhan nutrisi aiat
diperuhi olctr malanan keduaEa

7t.4''
Makanan Hrusus:
. benhrk: tair, lunalt padat
. ienis : jus, bis*uit, bubur eusu, nasi tim
. pemberian.ffilt"p r ienrs, konsistensi, tel6tur,
.S+(t
l.rs.\li
jumhh/l@li dan ft€kueftri/han
 3/24/2074

Memulai Makanan Padat

TidakErlalu dini (<4 bln)r
- berisiko teFedak
- rnengurangi asupan zat gizi
- risiko ahryi hbih besar

Perhatikan perubahan pada bayi yg

sedang tumbuh-kembang :
- keteramdlan moturik oral
-filriologi hrb{lh
(tungslslmn ffi, had' lidal, d[)
 3/24/20L4

Tes'tMakanan Pertamatt PANDUAN DASAR

l;=-] Umumnya: berupa bubur
beras vans diperkava zat
1. Urutan pemberian :
.
$hr,fu,J [Ei"n AAP : 6dak ada urutan khusus

Hanya l jenis (bukan 2. Tekstur:

I I kombinasi), bergizi, tekstur
halus dan konsistensi agak encer
. halus dan kongistensi ener pada awal
pemberian yang didngkadcn b€rtahap

Diberikan setelah minum ASI atau formula,

kecuali bila bayi menolak berulang atau 3, Besar porsi :
tampak tidak berminat )
berikan . mulal dgn Jumlah sedikit (1-2 sdk bh)
sebelumnya . bertahap ditambah ) l sdm atas lebih
sampai iumlahy.ng s€$lai

PANDUAN DASAR HATI - HATI !!

lfiroftel, bit bayam, sawi hijau dan lobak:
4. tarakwaktr antara pemb€rian makanan baru : I I . kandungan nitrat tingpi ) methemogbbinemia
I . titlak b<{e|r diberikan kpd bayi < 6 butan
- makamn b6ru b€rjarak+7 hari (rimFtablgi +) t
- pshatilan adanya rcaksi sinpang
- dicoba sahFpersatu Jenie makanan
- di6ba pada pagi hari,oleh ibu Madu:
It II udak bobh dtberikan pada bayi < 12 bolan )
c. botrlinum
5. Keamanan:
. Cuci tangan dan semua peralatan Susu SAPI (Whole Miilq, susu segar)t
. fidak menggunakrn peralatan mal@n . tirbk boHr diberilan lqd bayi < 12 buhn )
bersama-sama, atau mcngunyah makamn I I
bd$ih dahulu I I kandungan z3t beC rcndatr, tinggi kadar
[atrium, Kalium dan Chlor () beban ginjal)

LI
 3/2412AL4

BUBUR StJSU
Bohan : 2 sdm tePung beras (20 9r)
I
got*r, boyl untuh lebth
2 sdt gulc Posir (1O 9r)
I

mondirl:
1 gls susu s?4a? / 2 sdm penuh susu tePung
o befi frnsarf@dr
lo frngqrMr I
I Cora membuotnYo:
I

o minum dori conghir reioh I

tepung beros. guloposir dilarufkon dlm susu
udr 6-t bulon I
diotos cpi kecil, bicrkon hinggc rncsok sornbil dioduk
I Niloi gizi (bubur susu dengon susu segor)
. memegqnt t€ttdtri conghir I ]
Eneryi : 174 Kol
botol rutu Pmtein t 4.6 Er
r buct lodnrql makon Vit.A : 13O 51
Niloi gizi (bubur susu dengcn susu fepung)
i

redemlhion ruPc rchingPc ]

t€rtsdi ruto lopor dcn I

Energi I 213 Kal
henrrong yg tetgtur
I

I
Prrotein : 4.6 gr
l vit.A I 314 51

Ncsi Tim Bayi dengon TenPe

Bl{ dan bonyoknyo Energi Prot Vif A

A Kolori g SI
2C gr beros (2 sdrn) 72 1,4 0
25 gr tempz (1 ptg kecil) 37 4 ,5 15
'5
25 9r soyur boyom 9 0,8 152?
Fomily Foodr
(1/2 mongkok)
25 gr wofizl (1 Potong) 11 0,3 3000
10 gr rninyok goreng 90 0 0
(1 sdm)
219 7 4537,5
 3/24/2Ot4

Meals Frequency
s,.. Susu
Wb **" \
€:-4-"- \
t/--
Susu

€=?
- EF4KFASI

w-
sMcK ,, I 7a e*J
Ir"\-@ -/t/' (Susu) t=?
,. 3ta.te
I ,.-.*.
!rea!f,iP;
Qyy' "to"t
ilIODAY UEAL
rffimr
Fig, I t-3 my sftall child.en ned !o eal oftetr'

@usrre of ilrtrodudng
gagat pe"gaturan makan Pd baYi & Gomplernentory Foodr corarpoldr wlth
foodtedurc ctnd feedng rtYler

Arf,l- c lt lr lr . lt l. r lr .ll.lrlll1
a
Ace $rt{r-3m a-6m 6-lm l-tlm

SeqEfi Blgtnihl Fqhdd

e
Tdt@ *frinrd I p@ed ( thln od'*e*v for cerccd )
frched
c@.d I FiGly OEPPcd

I Oreeed
Fe€ding Bl6t Ming t BottL f4dttg
Stvl€t 5M Fecdka
Cup Feedno
9f faedh / Ftieet